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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2011 February;77(2):212-9

language: English

Selective decontamination of the digestive tract as infection prevention in the critically ill. A level 1 evidence-based strategy

Zandstra D. F. 1, Van Saene H. K. F. 2

1 Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands;
2 Department of Clinical Microbiology and Infection Control, Royal Liverpool Children’s NHS, Trust of Alderhey, Liverpool, UK


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Selective decontamination of the digestive tract (SDD) evolved into evidence-based medicine as a tool to prevent infections in critically ill patients. It significantly reduces mortality, pneumonia, bloodstream infections and the onset of resistance if the full four-component regimen is used. The use of only oral decontamination may reduce the incidence of pneumonia, but it has no significant impact on mortality. Moreover, the full SDD protocol significantly reduces the fecal carriage of multiresistant aerobic Gram-negative bacteria, whereas oral decontamination only is associated with increased carriage of multiresistant aerobic Gram-negative bacilli.

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d.f.zandstra@olvg.nl